AAFP Makes Extra Effort to Equip Members for ICD-10
New Resources Available
By Sheri Porter
The date for implementing ICD-10-CM is on the horizon. And to ensure that family physicians are ready, the Academy has added to its cache of resources ahead of the Oct. 1, 2013, implementation date.
Materials new to the ICD-10-CM resource site include
- ICD-10 Codes for Signs and Symptoms,
- ICD-10 Codes for Hypertension and Hypotension, and
- a presentation titled "5010 & ICD-10 Overviews" created by Cynthia Hughes, C.P.C., an AAFP coding and compliance specialist.
According to Hughes, the change from ICD-9 codes to ICD-10 codes will affect just about every family physician.
Similarly, the change to the 5010 transaction standards -- as mandated by the Health Insurance Portability and Accountability Act -- will affect all parties that send health information in electronic formats. For example, the new standards will affect patient eligibility inquiries and claims submissions, and thus, software vendors and clearinghouses, claims processors and payers, and physicians and other health care professionals.
"This is a significant change, and physicians need to get their practices ready," says Hughes.
Similarly, the change to the 5010 transaction standards -- as mandated by the Health Insurance Portability and Accountability Act -- will affect all parties that send health information in electronic formats. For example, the new standards will affect patient eligibility inquiries and claims submissions, and thus, software vendors and clearinghouses, claims processors and payers, and physicians and other health care professionals.
"This is a significant change, and physicians need to get their practices ready," says Hughes.
Billing Manager Stresses 5010, ICD-10 Readiness
Debbie Kalthoff echoes Hughes' concerns regarding practice readiness for ICD-10 and for 5010 transactions that go into effect on Jan. 1, 2012. As the billing manager for Meritas Health Corp., Kalthoff oversees the billing for seven hospital-owned primary care clinics and three subspecialty clinics. She has been deeply involved in preparing the practices that rely on her expertise for the change.
"If you're not ready for it, your claims are not going to go through, and you're not going to get any money. Your cash flow is going to suffer," she says.
Kalthoff advises practices to be in close touch with their software vendors. "The key is your software vendor, because the vendor is going to have to guide you through and help you," she notes.
For example, Kalthoff says her organization's software vendor -- who in her case also serves as the clearinghouse -- is in the "testing mode" and has been sending some test claims through to payers in the new 5010 format.
"They started testing last fall, and as of December, they only had one payer that was accepting 5010 transactions," says Kalthoff.
"If you're not ready for it, your claims are not going to go through, and you're not going to get any money. Your cash flow is going to suffer," she says.
Kalthoff advises practices to be in close touch with their software vendors. "The key is your software vendor, because the vendor is going to have to guide you through and help you," she notes.
For example, Kalthoff says her organization's software vendor -- who in her case also serves as the clearinghouse -- is in the "testing mode" and has been sending some test claims through to payers in the new 5010 format.
"They started testing last fall, and as of December, they only had one payer that was accepting 5010 transactions," says Kalthoff.
Academy Collaborates on 2011 ICD-10 Summit
In its extended push to help family physicians get ready for ICD-10 implementation, the Academy has signed on as a collaborating partner of the American Health Information Management Association ICD-10 Summit, which will be held April 11-12 in Baltimore.
AAFP members are eligible for a $200 discount on conference registration. Use coupon code MX5598 when registering for the event. Selected practice staff members -- those who belong to the American College of Medical Coding Specialists or the Healthcare Billing and Management Association -- also are eligible for the summit discount.
AAFP members are eligible for a $200 discount on conference registration. Use coupon code MX5598 when registering for the event. Selected practice staff members -- those who belong to the American College of Medical Coding Specialists or the Healthcare Billing and Management Association -- also are eligible for the summit discount.
